1. Mobile Health 2012May 17, 2012The Future of Baby StepsThe Health Benefits ofSuccess ExperiencesDavid S. Sobel, MD, MPHDirector of Patient Education and Health PromotionRegional Health EducationThe Permanente Medical Group, Inc.Kaiser Permanente Northern California510-987-3579david.sobel@kp.org1

2. Language MattersWhat is the origin of Baby Steps? a) Mother May I Game? b) Bill Murray? c) BJ Fogg?2 3. Is the baby in Baby StepsA B empowering? patronizing? inspiring? condescending? engaging? insulting?3 4. Do you prefer?A B Baby Steps? Simple Steps? Small Steps? Tiny Steps?4 5. The Holy Grail of Baby StepsWhat if baby steps do not lead to sustained behavior change and ongoing health habits?5 6. A Tale of Donkeyshttp://www.ishkbooks.com/mulla_nasrudin.html6 7. 7 8. How does behavior effect health?DIRECT EFFECTS of behavior change on health Exercise, diet, smoking, alcohol/drugs,sleep, preventive care, medicationadherence, etc.INDIRECT EFFECTS of successful change Enhanced mood and confidence8 9. The Mystery BeginsWe were able todemonstrate only weakassociations betweenchanges in behavior andchanges in health status.9 10. Chronic Disease Self-Management: Healthier Living- Managing Ongoing Health Conditions WorkshopSmall groups of people with different diseases2 hours a week for 6 weeksPeer-led workshopContent: skills for symptom management, exercise, nutrition, problem-solving, communication, advanced directiveProcess: Self-efficacy, action planning, sharing *Chronic Conditions Self-Management Program Lorig K, Holman H, Sobel D, Laurent D, Gonzalez V, Minor M: Living a Healthy Life withhttp://patienteducation.stanford.edu/ Chronic Conditions, Palo Alto, CA: Bull, 200610 11. Chronic Disease Self-Management: What we learned about OUTCOMESOutcomesImproves health behaviors, self-efficacy and health statusCost effectiveOutcomes are long-lasting and robustReplicableLorig K et al Medical Care 1999;37:5-14Lorig K, Sobel DS, Effective Clin Practice 2001;4:256-262Lorig K, et al Medical Care 2001;39:1217-122311 12. Chronic Disease Self-Management: What we learned about PROCESS Helping others helps People benefit themselves from helping other people Social comparison: Things could be worse Peer support and commitment Confidence counts Changes in health behaviors were not predictive of improvements in health outcomes Self-efficacy or confidence was associated with health outcomes Change the trajectory Lorig, Health Ed Quarterly 1992; Lorig K, Arthritis and Rheumatism. 1989; Ornstein R, Sobel D: Healthy Pleasures. 198912 13. Simple Steps to HealthSimple SimpleSteps Steps ExerciseConfidence Healthy Eating SustainedSuccess Optimism Smoking Health Habit Experience Self-Efficacy Preventive Care Mood etc.etc.Improved Improved Health Health13 14. So HOW can we create success?3 Brief Tales of Trout, Tide, and Tires14 15. Find their Passion What do youREALLY ENJOY?15 16. Discover their SolutionsTake yourmeds!Laundry Detergent16 17. Celebrate their Success17 18. Engaging People in Successful Change1. Find their Passion2. Discover their Solutions3. Celebrate their Success18 19. The Benefits of Failure?? Baby Steps approach is designed for success When might failure increase motivation, skill, and chances of future success? When might failure increase appreciation and celebration of future success?19 20. Thank you20 21. Resources for Change21 22. Making Change Easier22 23. Change and Willpower23 24. Resources for Emotional Health and Wellness24 25. Resources for Happiness and Wellness25 26. Resources for Happiness and Wellness26 27. Healthy Pleasures: 5 Part Online Video ProgramYouTubeHealthy Pleasures27